Idiopathic stenosis of foramina of Monro in an asymptomatic adult patient: a rare entity radiologists should be aware of

Abstract

Bilateral Adult Idiopathic Oclussion of Foramen of Monro is a rare entity, with less than 22 cases published in the literature so far, all of them symptomatic. 1 When the symptoms require it, the current first-line treatment is endoscopic foraminoplasty, sometimes associated with septum pellucidum fenestration, although some authors consider that a more conservative treatment in paucisymptomatic patients. 2 We report the case of an idiopathic biventricular hydrocephalus found incidentally in an asymptomatic 42-year-old female with temporomandibular joint disfunction. The fact that some patients with Monro foraminal stenosis may be asymptomatic increases the possibility of underdiagnosis, so we consider it a condition that radiologists should be aware of, mainly taking into account the fact that the diagnosis of this entity is usually radiologic 3 and the potential complications associated with treatment.

Lesions at the Foramen of Monro Causing Obstructive Hydrocephalus

“…Total surgical resection is the treatment of choice as these tumors are well demarcated, noninvasive and avascular. Role of postoperative radiation is debatable and is reserved in cases with subtotal surgical resection or in case of recurrence [71,72].…”

“…It can occur due to an absent or stenosed foramen of Monro or when a membrane occludes a normal sized foramen of Monro. Patients are usually asymptomatic but can occasionally present with symptoms of raised ICP [71,73].…”